Early Intervention for the Management of Acute Low Back Pain

Wand, Benedict M; Bird, C; McAuley, James H.; Doré, Caroline J; MacDowell, Maureen; Souza, Lorraine H. De

doi:10.1097/01.brs.0000143619.34308.b4

Cited by 134 publications

(50 citation statements)

References 20 publications

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“…The distribution of the variable symptom duration (number of days) appeared non-normal and was converted into both dichotomous and ordinal scales. Six weeks (45 days) was used as the threshold to dichotomize symptom duration (acute ≤ 6 weeks, chronic > 6 weeks) based on previous literature (Fritz et al, 2007b, 2008; van Tulder et al, 2006; Wand et al, 2004). Four demographic and history variables (Table 2) and seven physical examination variables (Table 3) were found to be correlated to one-week change in LM thickness (r pbis = −0.41 to 0.18, p < 0.15).…”

Section: Resultsmentioning

confidence: 99%

Association between history and physical examination factors and change in lumbar multifidus muscle thickness after spinal manipulation in patients with low back pain

Koppenhaver

Fritz

Hébert

et al. 2012

Journal of Electromyography and Kinesiology

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Understanding the clinical characteristics of patients with low back pain (LBP) who display improved lumbar multifidus (LM) muscle function after spinal manipulative therapy (SMT) may provide insight into a potentially synergistic interaction between SMT and exercise. Therefore, the purpose of this study was to identify the baseline historical and physical examination factors associated with increased contracted LM muscle thickness one week after SMT. Eighty-one participants with LBP underwent a baseline physical examination and ultrasound imaging assessment of the LM muscle during submaximal contraction before and one week after SMT. The relationship between baseline examination variables and 1-week change in contracted LM thickness was assessed using correlation analysis and hierarchical multiple linear regression. Four variables best predicted the magnitude of increases in contracted LM muscle thickness after SMT. When combined, these variables suggest that patients with LBP, (1) that are fairly acute, (2) have at least a moderately good prognosis without focal and irritable symptoms, and (3) exhibit signs of spinal instability, may be the best candidates for a combined SMT and LSE treatment approach.

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Section: Resultsmentioning

confidence: 99%

Association between history and physical examination factors and change in lumbar multifidus muscle thickness after spinal manipulation in patients with low back pain

Koppenhaver

Fritz

Hébert

et al. 2012

Journal of Electromyography and Kinesiology

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“…Only a few instruments were specific to single health disciplines, or single persistent pain constructs. The publication of assessment instruments appears to mirror developments in under-standing persistent pain behaviors and presentations, in terms of neuroanatomy, biology, physiology, psychology, and social science 5–14. However, no one instrument currently appears to assess all features of persistent pain, and thus multiple instruments are required to provide a comprehensive description of an individual with persistent pain.…”

Section: Discussionmentioning

confidence: 99%

“…There is convincing evidence that early identification of patients at-risk of developing persistent pain reduces disability and increases return-to-work rates 9–14. This paper reports on a systematic literature review that identified and critically appraised assessment instruments for persistent pain.…”

Section: Introductionmentioning

confidence: 99%

A review and critique of assessment instruments for patients with persistent pain

Grimmer

Vipond²,

Kumar³

et al. 2009

JPR

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BackgroundEarly identification of individuals at risk of developing persistent pain is important to decrease unnecessary treatment costs and disability. However there is scant comprehensive information readily available to assist clinicians to choose appropriate assessment instruments with sound psychometric and clinical properties.ObjectiveA national insurer commissioned the development of a compendium of assessment instruments to identify adults with, or at-risk of developing, persistent pain. This paper reports on the instrument identification and review process.MethodsA comprehensive systematic literature review was undertaken of assessment instruments for persistent pain of noncancer origin, and their developmental literature. Only assessment instruments which were developed for patients with pain, or tested on them, were included. A purpose-built ‘Ready Reckoner’ scored psychometric properties and clinical utility.ResultsOne hundred sixteen potentially useful instruments were identified, measuring severity, psychological, functional and/or quality of life constructs of persistent pain. Forty-five instruments were short-listed, with convincing psychometric properties and clinical utility. There were no standard tests for psychometric properties, and considerable overlap of instrument purpose, item construct, wording, and scoring.ConclusionNo one assessment instrument captured all the constructs of persistent pain. While the compendium focuses clinicians’ choices, multiple instruments are required for comprehensive assessment of adults with persistent pain.

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“…In addition, there is evidence that early intervention in general, and early treatment by physiotherapists in particular, for common musculoskeletal problems such as low back pain can reduce the amount of time people are off sick and can help to prevent acute problems from becoming chronic [5,44-46]. Although early intensive treatment is not always beneficial for recovery in musculoskeletal injuries [47], services that ensure timely access to care for musculoskeletal pain contribute importantly to patient experience and satisfaction [48].…”

Section: Arguments For Considering Other Models Of First-contact Carementioning

confidence: 99%

Taking responsibility for the early assessment and treatment of patients with musculoskeletal pain: a review and critical analysis

2012

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Musculoskeletal pain is common across all populations and costly in terms of impact on the individual and, more generally, on society. In most health-care systems, the first person to see the patient with a musculoskeletal problem such as back pain is the general practitioner, and access to other professionals such as physiotherapists, chiropractors, or osteopaths is still either largely controlled by a traditional medical model of referral or left to self-referral by the patient. In this paper, we examine the arguments for the general practitioner-led model and consider the arguments, and underpinning evidence, for reconsidering who should take responsibility for the early assessment and treatment of patients with musculoskeletal problems.

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Early Intervention for the Management of Acute Low Back Pain

Cited by 134 publications

References 20 publications

Association between history and physical examination factors and change in lumbar multifidus muscle thickness after spinal manipulation in patients with low back pain

Association between history and physical examination factors and change in lumbar multifidus muscle thickness after spinal manipulation in patients with low back pain

A review and critique of assessment instruments for patients with persistent pain

Taking responsibility for the early assessment and treatment of patients with musculoskeletal pain: a review and critical analysis

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